G_IPC_36 - Management of Patients with Clostridium Difficle (C.difficile) infection in the community

Clostridium difficile (C.difficile) is the major cause of antibiotic associated diarrhoea and colitis, a healthcare associated intestinal infection that mostly effects elderly patients with underlying diseases (DH 2006).

C.difficile is a spore forming, anaerobic bacterium. It is estimated that between 2-3% of healthy adults and up to 36% of hospital patients are asymptomatic carriers of C.difficile in their faecal flora. C.difficile associated disease (CDAD) is frequently associated with antibiotic treatment (Hawker et al 2001).

The diarrhoea associated with this disease can range in severity from mild to severe and can rapidly result in deterioration in the patient’s condition. The complications arising from this disease include; pseudomembranous colitis, toxic megacolon, colonic perforation and death.

C.difficile has the greatest potential for spread within in-patient units, thus prevention and appropriate management of infection is of paramount importance to quality and safety.

Preventing exposure to the organism. This may be done through routine infection control procedures. The most important aspects of this are:

  • hand washing by both staff and clients
  • appropriate disinfection and sterilisation of equipment
  • environmental cleaning
  • isolation of all clients with diarrhoea pending diagnosis

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